transplant 2

Question 1

allograft rejection depends on what?

Answer 1

1. Recognition of antigen
2. Activation of T cells (CD4)
3. Proliferation of T cells (CD4)

Question 2

what is hyperacute transplant rejection

Answer 2

Complement mediated and occurs immediately upon revascularization of the transplanted organ

Question 3

what is acute transplant rejection

Answer 3

Caused by infiltration of the allograft by T cells which causes inflammatory and cytotoxic effects on the graft•

Question 4

What is caused by antibodies directed against the vascular endothelium of the transplanted organ and is more difficult to treat than cellular rejection, but is usually responsive

Answer 4

vascular rejection (humoral rejection)

Question 5

What is caused by antibodies directed against the vascular endothelium of the transplanted organ. It is also more difficult to treat than cellular rejection, but is usually responsive

Answer 5

chronic rejection

Question 6

What labs are run before transplant occurs to prevent or minimize the risk of hyperacuteand acute rejection?

Answer 6

1. ABO blood testing (x2)
2. HLA (MHC) matching (kidney only)
3. Final crossmatching(x2)
4. Panel Reactive Antibody (PRA) (kidney only)

Question 7

Type A Blood is compatible with what other types?

Answer 7

compatible with A and O

Question 8

Type B Blood is compatible with what other types?

Answer 8

compatible with B and O

Question 9

Type AB Blood is compatible with what other types?

Answer 9

compatible with A, B, AB, or O (universal recipient)

Question 10

Type O Blood is compatible with what other types?

Answer 10

compatible with O (universal donor)

Question 11

what antigen is a major barrier to kidney transplants?

Answer 11

HLA antigens (especially HLA-DR)

Question 12

why are HLA antigen levels needed from donor in pre kidney transplant?

Answer 12

a recipient may have antibodies against donor HLA

Question 13

what is the ideal HLA antigen mismatch

Answer 13

zero

Question 14

what does it mean if agglutination occurs during T-cell and B-cell final cross match?

Answer 14

positive crossmatch, meaning recipient has preformed antibodies against the donor and hyperacute rejection would occur.

Question 15

what test is routinely performed on patients awaiting kidney transplantation measuring anti-human (HLA) antibodies in the recipients blood?

Answer 15

panel reactive antibody (PRA)

Question 16

what are 3 ways people often develop anti-HLA antibodies

Answer 16

1. Previous transplants
2. Blood transfusions
3. Pregnancy

Question 17

what are 4 ways panel reactive antibodies are removed before transplantation?

Answer 17

1. Rituximab
2. IVIG
3. Immunoadsorption columuns
4. Bortezomib

Question 18

High immunological risk patients should be induced with what

Answer 18

ATG (Rabbit)